Sexual violence is about a power imbalance. The perpetrator has the control at the expense of the rights and wishes of the victim. To prevent re-traumatisation of victim/survivors, those working with them aim to assist victim/survivors to regain power and control in their lives.
While being client led may seem simple, competing needs of agencies and professional roles, as well as personal and professional bias or influence of family members can result in the voice of the victim/survivor being lost or distorted (see the section on Independence).
The risk of ‘re-traumatisation’ is generally acknowledged in the context of the legal system. However, it is less obvious amongst generic health care workers. Astbury (2006) highlights that “the majority of survivors access primary health care services rather than specialist sexual assault services…” p 19. She emphasises the need for a different approach, especially in the context of intimate or intrusive physical examination:
“Primary health care providers have been trained to develop expertise in diagnosis and treatment of ill health and to act as authority figures in relation to their clients. As such, they become accustomed to devising treatment plans, giving advice and expecting clients to adhere to those plans and advice.
Increasing patient compliance may be desirable in other spheres of health care but it should not be a goal when working with victimised girls or women. Indeed it is likely to be highly counterproductive because it mimics the controlling behaviour of the perpetrator and reinforces the woman’s sense of powerlessness and lack of agency. Health care workers must strive to be as unlike the perpetrator as possible in all their interactions with victimised women. A non-directive, woman-centred therapeutic approach is indicated…” Astbury (2006) P 20
Challenging areas for the professional in being led by the wishes and view of victim/survivors include when:
- Child protection and working for the ‘best interests’ of the child can conflict with the child’s wishes and at times, non-offender parent/caregiver wishes
- Victim/survivors are too fearful to discuss issues and/or too distressed to make rational decisions. This includes when client choices are seen to be unwise or conflict with what staff feel is best for the client and ‘all concerned’.
- Mental health issues, developmental or other disabilities make it difficult to express views and wishes and when informed consent is not possible because of these disabilities
- Victim/survivors feel overwhelmed and want to hand all or some decision making to the advocate; “I don’t know what to do, you decide for me”, or “What would you do if you were me?”
- Limited resources, including the expertise of staff, compromise the ability to facilitate client wishes
- Feminist approaches emphasise the criminal nature of sexual and family violence. These views may not be shared by some families, particularly in some Aboriginal communities where sexual and family violence are seen as a consequence of cultural oppression with the legal/prison and child protection systems contributing to that cultural oppression
- When victim/survivors do not report to police or professionals
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The skills of client led advocacy are well known, however, they require consideration and application when assisting victim/survivors with complicating factors such as those above. Some areas to consider include:
- Viewing victim/survivors as their key informant regarding their view and wishes. This includes work with children and families (child informed decision making).
- Utilising trauma informed approaches, engagement and emotional support to ensure a sense of safety, trust and privacy. This on-going process is required to enable open discussion and exploration of issues.
- Listening skills as in the Egan model including recognising, avoiding roadblocks to effective listening and remembering to use basic counselling techniques.
- Discriminating between giving advice (to be avoided by advocates) and facilitating informed decision making which may include:
– helping to interpret complex information (take care with bias)
– non-directive guidance (making path options and consequences clear and helping clients clarify their priorities)
- Recognising the difference between gathering information to enable informed decision making by the client (advocacy) and assessment to enable case formulation and therapist led interventions (not advocacy)
- Providing options between facilitating and supporting self-advocacy (client represents her/himself) or representational advocacy (advocate represents client wishes). These options are provided for different situations.
“Strong advocacy and representations were important to victim/survivors, more so than the ability to have personal decision-making power. Indeed, as much as participants desired control over whether their case would proceed, decision-making power was identified as a potential burden of responsibility, and something that individual victim/survivors may not have the confidence or expertise to undertake”.
- Providing clients with a range of options which are easily understood. For example options include types of support, reporting, and release of information options
- Design procedures to actively involve victim/survivors in all levels of decision making as much as possible
- Victim/survivors are ‘kept in the loop’ regarding the progression and outcome of any decisions
- Where victim/survivors are unable to communicate their wishes because of physical or developmental issues or because they have not disclosed or presented for help, non-instructed advocacy techniques are used such as:
– non-verbal and other communication techniques to get to know and explore likely wishes and needs
– views of non-offender family and friends are obtained
– guided by rights literature including
the UN (1985) Declaration of Basic Principles of Justice for Victims of Crime and Abuse of Power
the UN Convention on the Rights of the Child.
– seeks supervisory support in cases of non-instructed advocacy and when victim/survivor wishes are different to what the advocate believes is in their best interest, or the wishes of parent/caregiver(s)
- Providing learning/consultative opportunities for non-specialist workers, particularly health workers, may help to develop client-led approaches
- Click here for Standard 2 – Advocacy is led by views and wishes of victims/survivors from “Advocacy Standards for working with Children, Young People and Adults who have Experienced Sexual Violence” (Australian).
- Click here for the Putting People First standards and indicators from Action for Advocacy (UK).
- Click here for Advocate on behalf of victims/survivors of sexual violence National Occupational Standards (UK)